目的:观察不同强度高频重复经颅磁刺激(high-frequency repetitive transcranial magnetic stimulation,HF-rTMS)对脑梗死恢复早期患者上肢功能障碍恢复的影响.方法:选取60例脑梗死恢复早期患者,采用随机数字表法分为HF-rTMS 80％RMT组、100％RMT组和假刺激组,每组各20例.三组患者均给予基础治疗(药物治疗及常规康复训练),在此基础上分别给予不同强度的HF-rTMS治疗.记录治疗前及治疗4周后3组患者的Fugl-Meyer上肢运动功能评定(Fugl-Meyer assement-upper extremity,FMA-UE)和改良Barthel 指数(modified Barthel Index,MBI)分值,检测运动诱发电位(motor evoked potential,MEP)潜伏期,计算中枢运动传导时间(central motor conduction time,CMCT),测量患侧大脑中动脉(middle cere-bral artery,MCA)血流速度.结果:治疗前,3组患者的FMA-UE评分、MBI评分、MEP潜伏期、CMCT及MCA血流速度均无显著性差异(P＞0.05).治疗4周后,3组患者的上述指标均较治疗前提高,具有显著性差异(P＜0.05);其中80％RMT组、100％RMT组指标改善均较假刺激组显著(P＜0.05);除MBI外,100％RMT组各项指标改善最为显著(P＜0.05).结论:HF-rTMS可以改善脑梗死恢复早期患者上肢功能和日常生活能力,100％RMT HF-rTMS在提高功能、运动神经兴奋性,改善脑血流等方面较80％RMT更有优势.
Effects of different intensity of high frequency repetitive transcranial magnetic stimulation on upper limb function in patients with early post-stroke
Objective:To evaluate the effects of high-frequency repetitive transcranial magnetic stimulation(HF-rTMS)of different intensities on the recovery of upper limb motor dysfunction in patients during the early recovery stage of cerebral infarction.Method:Sixty patients with cerebral infarction at early recovery stage were randomly divided into the HF-rT-MS 80％RMT group,the HF-rTMS 100％RMT group and the sham stimulation group,with 20 patients in each group.All three groups were also given basic treatment(medication and routine rehabilitation training).Be-fore and after 4 weeks treatment,the Fugl-Meyer Assessment-Upper extremity(FMA-UE)and Modified Barth-el Index(MBI),the latency of motor evoked potential(MEP).central motor conduction time(CMCT)and blood flow velocity of the ipsilateral middle cerebral artery(MCA)were recorded.Result:Before treatment,there were no significant differences in FMA-UE score,MBI score,MEP latency,CMCT and the blood flow velocity of MCA among the three groups(P＞0.05).After four weeks of treatment,the above indicators of the three groups were significantly higher than those before treatment(P＜0.05).More-over,the improvement of the indicators in the 80％RMT group and 100％RMT group were significantly higher than those in the sham stimulation group(P＜0.05).Except for MBI score,the improvement in all indicators in the 100％RMT group were the most significant(P＜0.05).Conclusion:HF-rTMS can improve upper limb function and activity of daily living during the early recovery stage of cerebral infarction.Compared with 80％RMT,100％RMT HF-rTMS has more advantages in improv-ing function,motor nerve excitability and cerebral blood flow.
cerebral infarctionhigh-frequency repetitive transcranial magnetic stimulationupper limb function
万方数据
维普
